TY - JOUR
T1 - Association between surgical procedures under general anesthesia in infancy and developmental outcomes at 1 year
T2 - The Japan Environment and Children's Study
AU - Kobayashi, Yoshiko
AU - Tokuda, Narumi
AU - Adachi, Sho
AU - Takeshima, Yasuhiro
AU - Hirose, Munetaka
AU - Shima, Masayuki
AU - Kamijima, Michihiro
AU - Yamazaki, Shin
AU - Ohya, Yukihiro
AU - Kishi, Reiko
AU - Yaegashi, Nobuo
AU - Hashimoto, Koichi
AU - Mori, Chisato
AU - Ito, Shuichi
AU - Yamagata, Zentaro
AU - Inadera, Hidekuni
AU - Nakayama, Takeo
AU - Iso, Hiroyasu
AU - Kurozawa, Youichi
AU - Suganuma, Narufumi
AU - Kusuhara, Koichi
AU - Katoh, Takahiko
N1 - Publisher Copyright:
© 2020 The Author(s).
PY - 2020/7/25
Y1 - 2020/7/25
N2 - Background: The neurotoxicity of general anesthesia to the developing human brains is controversial. We assessed the associations between surgery under general anesthesia in infancy and development at age 1 year using the Japan Environment and Children's Study (JECS), a large-scale birth cohort study. Methods: In the JECS, 103,062 pregnancies and 104,065 fetuses were enrolled between January 2011 and March 2014. Of the 100,144 registered live births, we excluded preterm or post-term infants, multiple births, and infants with chromosomal anomalies and/or anomalies of the head or brain. Data on surgical procedures under general anesthesia in infancy were collected from self-administered questionnaires by parents at the 1-year follow-up. Developmental delay at age 1 year was assessed using the Japanese translation of the Ages and Stages Questionnaires, Third Edition (J-ASQ-3), comprising five developmental domains. Results: Among the 64,141 infants included, 746 infants had surgery under general anesthesia once, 90 twice, and 71 three or more times. The percentage of developmental delay in the five domains of the J-ASQ-3 significantly increased with the number of surgical procedures. After adjusting for potential confounding factors, the risk of developmental delays in all five domains was significantly increased in infants who had surgery under general anesthesia three times or more (adjusted odds ratios: for communication domain 3.32; gross motor domain 4.69; fine motor domain 2.99; problem solving domain 2.47; personal-social domain 2.55). Conclusions: Surgery under general anesthesia in infancy was associated with an increased likelihood of developmental delay in all five domains of the J-ASQ-3, especially the gross motor domain at age 1 year. The neurodevelopment with the growth should be further evaluated among the children who had surgery under general anesthesia. Trial registration: UMIN Clinical Trials Registry (number: UMIN000030786).
AB - Background: The neurotoxicity of general anesthesia to the developing human brains is controversial. We assessed the associations between surgery under general anesthesia in infancy and development at age 1 year using the Japan Environment and Children's Study (JECS), a large-scale birth cohort study. Methods: In the JECS, 103,062 pregnancies and 104,065 fetuses were enrolled between January 2011 and March 2014. Of the 100,144 registered live births, we excluded preterm or post-term infants, multiple births, and infants with chromosomal anomalies and/or anomalies of the head or brain. Data on surgical procedures under general anesthesia in infancy were collected from self-administered questionnaires by parents at the 1-year follow-up. Developmental delay at age 1 year was assessed using the Japanese translation of the Ages and Stages Questionnaires, Third Edition (J-ASQ-3), comprising five developmental domains. Results: Among the 64,141 infants included, 746 infants had surgery under general anesthesia once, 90 twice, and 71 three or more times. The percentage of developmental delay in the five domains of the J-ASQ-3 significantly increased with the number of surgical procedures. After adjusting for potential confounding factors, the risk of developmental delays in all five domains was significantly increased in infants who had surgery under general anesthesia three times or more (adjusted odds ratios: for communication domain 3.32; gross motor domain 4.69; fine motor domain 2.99; problem solving domain 2.47; personal-social domain 2.55). Conclusions: Surgery under general anesthesia in infancy was associated with an increased likelihood of developmental delay in all five domains of the J-ASQ-3, especially the gross motor domain at age 1 year. The neurodevelopment with the growth should be further evaluated among the children who had surgery under general anesthesia. Trial registration: UMIN Clinical Trials Registry (number: UMIN000030786).
KW - Ages and Stages Questionnaires (ASQ)
KW - Development
KW - General anesthesia
KW - Infant
KW - Japan Environment and Children's Study (JECS)
KW - Neurotoxicity
KW - Surgery
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U2 - 10.1186/s12199-020-00873-6
DO - 10.1186/s12199-020-00873-6
M3 - Article
C2 - 32711462
AN - SCOPUS:85088624242
VL - 25
JO - Environmental Health and Preventive Medicine
JF - Environmental Health and Preventive Medicine
SN - 1342-078X
IS - 1
M1 - 32
ER -